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'Fixing Mommy'

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How expert abdominal wall surgery gave new life to one North Texas mom

Kathleen Pritchard, 35, leads an active life. As a stay-at-home mom and home-schooler of four young children, she is constantly on the go. There was a time, however, when she could barely go anywhere because of a complex abdominal wall hernia that not only affected her appearance but dramatically impacted her ability to care for her family. Life, it seemed, had changed, and Kathleen didn’t think there was anything she could do about it. Then she found out she could.

In 2005, after the birth of their second child, Kathleen and her husband, Brad, were medically advised to avoid future pregnancies because of a thinning of her uterine lining and weakening of her abdominal muscles. Fate, however, had other plans, and, in 2008, the couple welcomed their third child. It was not an easy pregnancy.

Touch and Go

A petite woman at 5 feet tall, Kathleen nonetheless gave birth to large babies. Kaylen, now 10 years old, was 8 pounds, 1 ounce at birth; Joshua, 8, was 7 pounds, 9 ounces.

“After Kaylen, my belly pretty much went right back to normal,” Kathleen recalls. “But then with Joshua, six months postpartum I still looked like I was about six months pregnant. I just kind of figured, you know, that’s the way it’s going to be.”

The second pregnancy had stretched Kathleen’s abdominal muscles and caused a relatively small abdominal wall hernia to develop, which was discovered after Joshua’s birth. The third pregnancy exacerbated the problem.

“At around 32 weeks, my uterine lining was stretched so thin that you could see the baby moving inside,” she says. “We were concerned whether I was going to be able to carry him to term because there just didn’t seem to be enough of me to hold him in. I wore a belly band that helped support him, but it was pretty crazy.

“One thing I couldn’t do was lift anything heavier than a gallon of milk,” she recalls. “Joshua was still in the crib at the time, and I couldn’t even lift him in and out. Our lives were turned upside down.”

Kathleen’s retired father drove 45 minutes daily to Keller, where the Pritchard family was living at the time, to help in whatever way he could while Brad worked. The rest of the time Brad took on the job of both mom and dad, with never a complaint, Kathleen says.

Thanks to extreme caution and the indefatigable assistance of her father and husband, Kathleen carried the third baby to term, and, in May 2008, Andrew was born. He weighed a healthy 9 pounds. But Kathleen’s condition was not good.

Sidelined

The small hernia Kathleen had developed after her second pregnancy had now become much larger and protruding, making her stomach look as if she were still eight months pregnant even after her new baby was born, she says. What was worse, though, was because she now lacked a strong abdominal wall to protect her organs, she could not get down on the floor and play with her three active children or take part in any physical activities. Her condition effectively sidelined her from her children’s lives.

“My daughter, who was 4 at the time, just didn’t understand that it wasn’t because I didn’t want to play, but that I just couldn’t,” Kathleen recalls. “It broke my heart, and finally I just said, ‘I don’t want to live like this any longer!’”

Determined to resolve the hernia, Kathleen and Brad met with a series of plastic surgeons from across the Metroplex. When they met Ronald Hoxworth, M.D., Director of UT Southwestern’s Abdominal Wall Reconstruction Program, Kathleen says she immediately knew he was the doctor for them.

“He had the greatest bedside manner,” she says. “He was so knowledgeable. I was scared and unsure about what was going to happen to me or what was wrong with me, and he explained all of it.”

It was the way Dr. Hoxworth explained her condition to the children, though, that sealed the Pritchards’ decision, Kathleen says.

“Kaylen and Joshua were young, but they were old enough to know that something was going on and to be upset by it,” Kathleen says. “Dr. Hoxworth got down to my kids’ level, literally, to explain the surgery to them. He drew pictures for them to help them understand what was happening, and that, for me, was huge. No other doctor did that.”

Dr. Hoxworth remembers their initial consultation well.

“Her little girl said to me, ‘Doctor, are you going to fix my mommy? She’s broken.’ It was so touching. Mrs. Pritchard started to well up, and that gave me a sense of how dramatically this hernia had affected her life,” he says.

A Transformation

Dr. Hoxworth performed a complete abdominal reconstruction and realigned all of Kathleen’s abdominal muscles, followed by a tummy tuck. The procedures corrected the hernia and transformed Kathleen from a size 14 to a size 2.

“I’m back to my high-school size, which I never dreamed could happen!” she says. “More importantly, I feel whole and un-broken again, and I’m so thankful to Dr. Hoxworth for that. At one of my post-op appointments, I gave him a big hug and started crying. I told him he’d changed my life, and he teared up, too.”

Dr. Hoxworth says helping his patients is easily the best part of his job. He notes that hernias are not only functional problems, but when they limit a person’s normal activity, they become social and emotional issues as well.

“Sometimes people are afraid to ask about a hernia because they think there’s nothing that can be done about it, but, in reality, it can be fixed,” he says. “By treating a large number of patients with complex problems, I’ve been able to develop and refine techniques that offer leading-edge reconstructive options for my patients. I can often reassure them that their situation is not the worst I’ve seen – not even the worst I’ve seen that week – and that I’ve helped someone similar to them previously.”

Kathleen says Dr. Hoxworth’s help affected every member of her family. Almost five years now since her surgery, she says she is as active today as she’s ever been. In part, that’s because her children have grown and are now even busier, but it’s also because the size of the Pritchard family has meanwhile expanded: They adopted a boy named Isaya, who is now 2. Life is good.

Abdominal Wall Hernias: "Often Overlooked"

While the extent of Kathleen Pritchard’s condition was extreme, abdominal wall hernias in general are “more common than we realize,” says UT Southwestern’s Dr. Ronald Hoxworth, an expert at repairing even the most complex of cases.

“It’s not uncommon for someone to come in for a ‘mommy makeover,’ where they’re thinking about getting liposuction or a tummy tuck, and in the course of the examination we’ll note that they have a hernia, and they didn’t even realize it. The point is that it can often be overlooked.”

Typical symptoms of an abdominal wall hernia include a noticeable bulge or dull stomach pain or cramping after eating or being active – or even just an uncomfortable feeling of weakness in the core muscles of the abdominal wall. The condition often develops in patients who’ve had multiple pregnancies or surgeries.

Dr. Hoxworth adds that the condition can worsen if not addressed. ”If there’s any question in your mind, don’t hesitate to get examined,” he advises.